Provider Demographics
NPI:1366782906
Name:LINDSEY, STEPHEN
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 PARK AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3531
Mailing Address - Country:US
Mailing Address - Phone:901-685-1152
Mailing Address - Fax:901-682-6846
Practice Address - Street 1:5180 PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3531
Practice Address - Country:US
Practice Address - Phone:901-685-1152
Practice Address - Fax:901-682-6846
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3919332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies